Lawrence Lottenberg: Demise of the trauma system


Published: Monday, April 29, 2013 at 6:01 a.m.
Last Modified: Thursday, April 25, 2013 at 11:16 p.m.

I have spent 33 years of my life caring for injured citizens in Florida, the last 10 here in Gainesville establishing a world class Level I Trauma Center at Shands&UF. The trauma system is in real jeopardy for the first time in my career.

The legislature is considering SB 966 and HB 817, and legislation to delete FS 395.4025 regarding the process for the designation trauma centers in Florida. While the intent of this legislation is to improve access for the injured patient to the state trauma system and improve state trauma center standards to match national standards, as written these amendments will achieve neither of these goals and will destroy decades of trauma system development in Florida.

Today, pre-hospital emergency medical resources, statewide injury triage guidelines and broad geographic distribution of the state's designated trauma centers ensure that 96 percent of the population can reach a trauma center within 85 minutes of injury (the golden "hour" of trauma care). Ninety six percent of Floridians lived in an area already routinely served by at least one established trauma center, and nearly all severely injured children and severely injured adults were actually treated in those centers.

Moreover, care delivered in these centers conferred an 18 percent survival advantage and a substantial cost savings. This is an extraordinary public health success story that was brought about by public policy guided by scientific study and a collaborative relationship between trauma subject matter experts and the department of health.

The legislation being considered threatens to completely undo more than three decades of effort by taking the designating authority from the department of health and allowing the unregulated designation of new trauma centers.

The citizens of Florida and the legislators of our state need to let all of the trauma experts, including the Florida Committee on Trauma and the Department of Health, continue to work to preserve the trauma system in our state and not take legislative action to satisfy the whims of a few legislators who want a new trauma center in their region and on every corner of every city in Florida.

Dr. Lawrence Lottenberg is an associate professor of surgery and anesthesiology at the University of Florida College of Medicine.

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